Mrs Debra Pickrell A/Manager Patient Services and ...
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Mrs Debra Pickrell A/Manager Patient Services and Information Department
Transcript of Mrs Debra Pickrell A/Manager Patient Services and ...
Mrs Debra Pickrell
A/Manager Patient Services and Information Department
Concord Hospital is a Tertiary Referral Hospital delivering a broad range of specialities and subspecialties.
Fifteen Surgical Specialities & Eighteen Medical Specialties
(approximately 180 doctors with admitting rights)
Eleven Operating Theatres (nine utilised routinely for Elective
cases) In 2012, 9509 Elective surgery cases performed (12,188 including Emergency cases). 1,806 Ready for Care (RFC) Patients on the waiting list (Dec 2012)
The “Booking Office”.
Clear Policy and Business rules.
Six Components of the Booking Process.
Good Communication and Support.
Maintaining Focus.
Centralised Admissions/Wait List Management Department (Main Entrance)
Staff trained in all booking functions with a
‘can do’ attitude The need to move all components of the
booking process routinely. (Staff on rotating shift times & duties attached to shifts not staff members).
Supported by all levels of staff.
Our Booking Office staff received the CRGH ‘Team of the Quarter’ award in
2012.
RFA MANAGEMENT
PLANNING
SCHEDULING
COMMUNICATION
MAINTENANCE
MONITORING
RECEIPT
CHECK
STORE
Date stamp
Mandatory data provided. CPC indicated appropriate. Procedure not Cosmetic or
Discretionary Surgery. Consent completed. Patient ready for care. Transfer from receiving tray to
action trays.
Secure and easy to locate.
PRIORTISE
PRIORITISING
RFA’S TO PROCESS
Tray 1
Tray 2
Tray 3
Medical & Surgical
‘Urgents’
Procedure date
within 4 weeks
Category A Waiting
List &
Cancellation/
Deferment
requests.
Medical Admissions
Procedure date > than 4 weeks.
Surgical Admissions
Procedure date > than 4 Weeks.
Tray 4
Tray 5
Tray 6
Category B
Waiting List.
Category C
Waiting List
Category D
Staged Waiting List
WAITING
(NO PAD)
BOOKED
(WITH PAD)
REMOVALS
PREPPED
FOR ADMIT
RFA STORAGE
RFA STORAGE SYSTEM – By Specialist Surname
RFA’s WITHOUT A PAD
RFA STORAGE SYSTEM – by Planned Admission Date
RFA’s WITH A PAD
RFA STORAGE SYSTEM
PREPPED FOR ADMISSION
Projecting several months ahead.
Obtain Surgeon’s leave plans (e.g conferences, annual leave, etc).
Weekly review of the Theatre Session plan (Three months in advance) .
Building the theatre lists 6 weeks to three months ahead.
• Identifying Patients needing Theatre time & Theatre time needing Patients.
• Leave Survey distributed quarterly by the Booking Office.
• Weekly meeting held with SNM OT, Mgr
Admissions and Director Anaesthetics.
to ensure all OT are sessions are being utilised.
• Assists with projecting demand.
• Patients receive adequate notice.
Weekly meeting (Wed)
SNM Operating Theatres
Mgr Patient Registration (Admissions)
and Director Anaesthetics.
Cases are scheduled by; Protocol (Booking Staff)
or Surgeon indication (Specialist/Registrar)
Booking Staff 38% Specialist 52% Registrar 5%.
Within CPC Timeframe and Listing Date Order (treat in turn).
• Waiting List reports used are sorted by;
Doctor, CPC and chronological listing date order (except for Cat D).
Cat D case are sorted by Status
Review date (SRD), in three groupings;
- Deferred
- Staged (unfit)
- Staged (periodic review).
• Partial Booking in advance to allow for
Cat A & B cases.
• PAS rules in place to assist staff.
System rules and warning messages that appears when booking staff schedule a case outside the CPC timeframe..
RUNDATE: 31/01/2013 CONCORD REPATRIATION GENERAL HOSPITAL PAGE: 1
RUNTIME: 08:12 WAITING PATIENTS WITHOUT DATE (PAD) BY SPECIALIST BY CPC
SPECIALTY: UROLOGY SPECIALIST: DOCTOR, A CPC: B
______________________________________________________________________________________________________________
LIST DATE MRN PATIENT's NAME STANDBY SEX F/CLS SUBURB PLANOPER/PROC OPTM REVIEW DT DEL CNT DEF CNT PHONE
-------- --- -------------- ------- --- ----- ------ ------------- ---- --------- ------- ----- -----
07/12/2012 707873 B. ZAPPAVIGNA M NC RYDE FLEXIBLE CYSTOSCOPY 015 0 0
12/12/2012 1146992 I. ROY F NC STRATHFIELD FLEXIBLE CYSTOSCOPY 010 0 0
SPECIALTY: UROLOGY SPECIALIST: DOCTOR, A CPC: C ______________________________________________________________________________________________________________
LIST DATE MRN PATIENT's NAME STANDBY SEX F/CLS SUBURB PLANOPER/PROC OPTM REVIEW DT DEL CNT DEF CNT PHONE
-------- --- -------------- ------- --- ----- ------ ------------- ---- --------- ------- ----- -----
08/05/2012 1164352 C. ISHAK M NC SOUTH CIRCUMCISION 030 1
08/05/2012 1164353 J. MARUNA M NC AUBURN CYSTOSCOPY + TUR PROSTATE 060 0
08/05/2012 1158974 J. SAPIANO M NC GREYSTANES CYSTOSCOPY + TUR PROSTATE + LITHOTR 0 0
SPECIALTY: UROLOGY SPECIALIST: DOCTOR, A CPC: D
______________________________________________________________________________________________________________
W/L STATUS : Deferred ------------
LIST DATE MRN PATIENT's NAME STANDBY SEX F/CLS SUBURB PLANOPER/PROC OPTM REVIEW DT DEL CNT PHONE
-------- --- -------------- ------- --- ----- ------ ------------- ---- --------- ------- -----
02/11/2012 1178429 S. MAHMOUD F NC BANKSTOWN LEFT URETHEROSCOPY + LASER LITHOTIP 030 01/03/2013 0
12/12/2012 1169958 S. SHANG M NC CABRAMATTA RADICAL PROSTATECTOMY + PELVIC NODE 80 01/03/2013 0
W/L STATUS : Staged Reason: Unfit for Surgery ------------ -------
LIST DATE MRN PATIENT's NAME STANDBY SEX F/CLS SUBURB PLANOPER/PROC OPTM REVIEW DT DEL CNT PHONE
-------- --- -------------- ------- --- ----- ------ ------------- ---- --------- ------- -----
03/10/2012 482657 J. CLIFTON M PI AUBURN CYSTOSCOPY + BLADDER DIATHERMY 030 01/02/2013 0
20/02/2012 1037294 J. HOLLEIS M NC FAIRFIELD FLEXIBLE CYSTOSCOPY Unk 01/02/2013 0
W/L STATUS : Staged Reason: Periodic Treatment ------------ -------
LIST DATE MRN PATIENT's NAME STANDBY SEX F/CLS SUBURB PLANOPER/PROC OPTM REVIEW DT DEL CNT PHONE
-------- --- -------------- ------- --- ----- ------ ------------- ---- --------- ------- -----
02/03/2012 824475 L. DESOUZA M PI HORNSBY FLEXIBLE CYSTOSCOPY 015 01/03/2013 0
At the time of scheduling the admission and surgery dates the Bookings staff also organise;
The Preadmission Clinic Appointment & Preadmit Booking Interview (same day)
Interpreter (if applicable)
Transport (if applicable)
Hostel Accommodation (if applicable)
Financial quotes for accommodation and medical expenses (Medicare Ineligible and Private Uninsured Patients).
Anaesthesia Cost enquiry proformas.
Generate and provide Notification Letters / Information Packages / Pre-Procedure Health Questionnaire and Registration form.
Patients
GP Specialists
Letters - Waiting List, Admission, delay, deferral, removal letters.
Phone calls
Approx Waiting Times.
Information booklets, Pre-Procedure Health Questionnaire & Patient Registration Form.
Confirmation of Admission date.
SMS appointment Reminders (PAC)
Letters - Wait List notification, Admission advice and waiting list removal notifications.
Letters – additions and removals from their Waiting list.
Weekly reports – Theatre schedule and Waiting List.
Leave Survey
Fax Back Requests for additional information (RFA Check)
Theatre Staff
Pre-Admission Clinic Staff
Bed Management
Surgical Admissions Ward (DOSAC)
• List changes and Late Additions.
• Flagging Patients that have been delayed before.
• Flagging Patients close to CPC timeframe expiration.
• Theatre Utilisation.
• Clinical Alerts – display on
OT list (e.g Diabetic, Isolation, etc)
• Country Patients - Health Plan’s.
• Procedure date changes
(e.g Patient unfit for surgery).
• Late additions/beds/extra workload.
• Notifying patient of admission times (staggered times), final check.
Generating and distributing the appropriate Electronic letters;
Waiting List advice letters
Patient
GP
Admission Advice Letters
Patient
GP
Delay and Deferral Letters
Patient
Removal Letters
Patient
GP
Attending Medical Officer
Patients asked to confirm within seven working days of
Admission Advice letter being received.
PAS field used to flag Confirmation.
Confirmation Report generated to identify Patients who
have not confirmed their admission date and followed
up.
Patients that fail to attend (FTA) their Pre-Admission
Clinic appointments are followed up next day
(phone call).
RUNDATE: 20/12/2012 CONCORD REPATRIATION GENERAL HOSPITAL
RUNTIME: 15:21 CONFIRMATION REPORT FOR BOOKED PATIENTS PAGE: 1
FROM: 08/02/2013 TO: 08/02/2013
PLANNED ADMISSION DATE: 08/02/2013
-----------------------
MRN SURNAME GIVEN NAME F/CLS VISIT ID CPC LIST DATE FLAG AMO WARD UNIT ENCNTR
TYPE
--- ------- ---------- ----- -------- --- --------- ---- --- ---- ---- ----
1126337 HOGGARD KELLIE PI - P6831183 D 07/12/2012 Confirmed STEWART, PETER 1W-ACE
COLORECTALSURGERY Booking/No PAC
PHONE: 0298881184 ADDRESS: 32 Bruce St RYDE 2112
1113528 ALKISA HANY NC - N6556874 D 16/02/2012 Letter Sent BOUSTRED, ROBER DOSAC ENT
Booking/PAC Defer
PHONE: 0298232023 ADDRESS: 23B Alamein Road BOSSLEY PARK 2176
1147353 HAYES TIMOTHY NC - N6453861 D 28/09/2011 Confirmed BOUSTRED, ROBER DOSAC ENT
Booking/No PAC Defer
PHONE: 0243686469 ADDRESS: 42 Undara Road BENSVILLE 2251
1133042 ANDERSON SUZANNE PU - P6632001 D 16/05/2012 Unconfirmed GHABRIAL, RAFAT DOSAC
OPHTHALMOLOGY Booking/No PAC Defer
PHONE: 0457722052 ADDRE
SLHD Director Operations
General Manager
Department Head of Surgery
Department Head/s
Doctor
Admissions Supervisor
Booking staff
MOSTLY NEVER
NEED TO
ESCALATE PAST
THIS POINT
Keep the list ‘Clean’.
Action all changes efficiently.
(eg. Delays, Deferrals, Removals, Patient details, etc).
Clerical Audit program in place;
Reconfirmation of those waiting longer than 6 months.
Surveillance for those admitted through ED.
Follow-up of FTAs
Follow-up of delayed patients
Review Deferred & Staged (unfit) patients
Duplications
Audit
Methodology (Audit Type -
Report/Phone/Letter)
Action completed for the
month
Outcome / Comment
Patients wait listed > 6mths.
Ascertain if patients still
require their procedure.
Confirm if they are ready for
care or if they have already
had them done elsewhere.
Electronically generated
Letters printed daily.
Report (WL-audit no replies)
generated daily.
Yes / No
Yes / No
Total Number of Letters sent:
Number of “non response to
audit letter patients” removed
for the month:
Multiple Bookings (Duplicate) bookings
Report (Area WL – Multiple
entries - detail) generated
weekly to identify duplicate
bookings at CRGH
Yes / No
Number of duplicate bookings removed for the month:
Appropriate CPC assigned for
procedure in eMR.
Screening by Central Bookings
staff prior to processing RFA.
Report generated weekly by
Supervisor to ensure CPC
allocated for IPC is in
accordance with MOH
Accepted CPC guidelines.
Yes / No
Yes / No
Number of CPC corrections
made for the month:
Review Bookings that have
exceed PAD
Report generated daily.
Bookings removed,
rescheduled or admitted where
appropriate.
Yes / No
Number of patients on the FTA
at the end of each month:
Audit
Methodology (Audit Type -
Report/Phone/Letter)
Action completed for the
month
Outcome / Comment
Identify patient admitted via
the Emergency
Department that have a
Waiting List booking
encounter
Report (WL – waiting patients
admission via Emergency)
Generated daily.
Medical teams contacted to
ascertain if elective
procedures will be done
whilst patient in hospital.
Yes / No
Yes / No
Number of waiting list
bookings removed:
Ensure Delayed Patients are
rescheduled for the next
available OT session.
Report (Delayed > one
report) generated weekly.
PAD allocated in consultation
with AMO.
Yes / No
Number of patients delayed
without a PAD at the end of
the month:
Review Status Review Dates
Report generated every three
weeks. Staged cases
scheduled for appropriate
timeframe. CPC A, B & C
cases returned to RFC status
or date scheduled where
appropriate.
Yes / No
Number of patients removed
from waiting list due to
review:
Removal Detail Report
provided to Medical Director
for signature
Removal Summary Report.
Report generated – Summary
provided to Medical Director.
(Removals report summary)
generated at the end of each
month.
Yes / No
Yes / No
Copy attached to Clerical
Audit Outcome Report.
Audit
Methodology (Audit Type -
Report/Phone/Letter)
Action completed for the
month
Outcome / Comment
Theatre schedule & Waiting
List reports forwarded to
Doctors.
Report generated weekly.
Scanned & emailed.
Yes / No
Clear audit trail
documenting changes made
to Patients booking.
Delay/Deferral, Removal,
CPC & Supporting
Documentation attached to
RFA’s.
Random audit of RFA’s &
eMR performed quarterly.
Yes
Yes / No
Quarterly RFA Compliance
Audit & Data
Quality/Process Audit
Results
Problems Identified during
the Monthly Audit:
Recommendations for
Improvement:
Person who conducted
Clerical Audit of Waiting
List:
Name:
Signature: Date:
Manager Patient
Registration sighted Report:
Name:
Signature: Date:
Constantly monitoring changes.
Wait list report by CPC, highlighting unallocated cases
and their due date.
Weekly meeting with Director Anaesthetics, SNM OT
and Admissions Supervisor Weekly meetings .
Communicating with decision makers.
Widespread awareness of goals.
Funding-related motivation has helped focus on
common goals.
Strong collaborative approach to achieve outcomes.
Clinical and corporate leadership.
Escalation System.
Key Performance Indicators / Funding
Performance Agreements Staff meetings with the booking staff
Weekly meetings: Head of Anaesthetics and SNUM theatre
General Manager
SLHD Director of Clinical Operations (Teleconference)
Patient Administration System reports weekly Facility data reports produced monthly
SLHD dashboard produced monthly Report used to monitor patients approaching
due date Booking and Wait List Reports sent to surgeons weekly.
